Pregnancy outcome in women presenting with pre-eclampsia at less than 25 weeks gestation
Article first published online: 30 AUG 2006
Australian and New Zealand Journal of Obstetrics and Gynaecology
Volume 46, Issue 5, pages 407–412, October 2006
How to Cite
BUDDEN, A., WILKINSON, L., BUKSH, M. J. and McCOWAN, L. (2006), Pregnancy outcome in women presenting with pre-eclampsia at less than 25 weeks gestation. Australian and New Zealand Journal of Obstetrics and Gynaecology, 46: 407–412. doi: 10.1111/j.1479-828X.2006.00626.x
- Issue published online: 30 AUG 2006
- Article first published online: 30 AUG 2006
- Received 04 May 2006; accepted 01 June 2006.
- early onset pre-eclampsia;
- maternal morbidity;
- perinatal morbidity
Objective: We aimed to (i) assess maternal and perinatal outcomes in pre-eclampsia at < 250 weeks; and (ii) determine if any antenatal factors were associated with adverse maternal and perinatal outcomes.
Design: A retrospective study.
Setting: Tertiary referral hospital, Auckland, New Zealand.
Methods: Data were extracted from the clinical record and hospital database. The study population involved women admitted with pre-eclampsia at < 250 weeks, with a live singleton pregnancy, from 1997 to 2004 and managed expectantly.
Outcome measures: Maternal morbidity, perinatal death, neurodevelopmental outcome at 18 months, small for gestational age assessed by population and customised birthweight centiles.
Results: Gestation at admission was the only antenatal variable associated with adverse perinatal outcome. Of 14 women admitted < 23 weeks, no babies survived, but eight (62%) babies of women admitted in the 24th week (240−246) survived. Neurodevelopmental outcome was assessed in eight of nine survivors; two (25%) had moderate and two (25%) had minor disability. All babies in this cohort had birthweights < 5th customised centile. Only one baby (10%) weighing < 500 g survived.
Conclusion: Maternal morbidity was high in this expectantly managed cohort. As no babies survived when pre-eclampsia occurred before 23 weeks, induction of labour should be considered. In the 24th week two-thirds of babies survived and 25% had moderate handicap. This information may help clinicians and women in the future to make informed choices about management.